User:Daniellelp/sandbox

I'm working on the "Causes" and "Epidemiology" sections of the article on vocal fold paresis. For the "Causes" section, I will think about reformatting the information to improve its organisation (e.g. bullet points under each sub-heading).

Causes
There are a wide variety of possible causes of vocal fold (VF) paresis, including congenital (i.e. present at birth) causes, infectious causes, malignancies and tumors, traumatic causes, endocrinologic diseases, and systemic neurologic diseases.

Congenital Causes
Conditions present at birth that can cause VF paresis include hydrocephalus, Arnold-Chiari malformation, tracheoesophageal fistula, vascular anomalies (e.g. vascular ring), dysmorphic syndromes (e.g. Mobius, Goldenhaar), syndromes affecting brainstem function, and neuromuscular disorders such as Charcot-Marie-Tooth.

Infectious Causes
Many viral infections have been reported as a cause for VF paresis, including herpes simplex virus, Epstein-Barr virus, Varicella-Zoster, cytomegalovirus, HIV, West Nile virus, and upper respiratory infection. Bacterial infections have also been reported to cause VF paresis, such as syphilis and Lyme disease.

Traumatic Causes
VF paresis can result from trauma to one of more laryngeal nerves during intubation, surgery (e.g. thyroidectomy, spine surgery, carotid endarterectomy, vagal nerve stimulator implantation ), injection of botulinum neurotoxin, or penetrating neck trauma.

Endocrinologic (Thyroid) Diseases
Causes of VF paresis also include diseases of the thyroid gland, such as hypothyroidism, goiter, and thyroiditis.

Systemic Neurologic Diseases
Examples of systemic neurologic diseases that may cause VF paresis include myasthenia gravis, Charcot-Marie-Tooth, multiple sclerosis, and spinocerebellar atrophy. Systemic rheumatological diseases (e.g. sarcoidosis, rheumatoid, scleroderma) have also been reported as causes for VF paresis.

Epidemiology
Due to the complex and controversial nature of this condition, epidemiological reports vary significantly and more research in this area is needed. Instead of reporting the incidence of this condition within the general population, most studies are conducted within specialized voice disorder clinics. In such a setting, one study found that approximately 26% of patients are diagnosed with paralysis or paresis of the vocal folds. Yet, incidence rates as high as 80% for vocal fold paresis have been reported elsewhere. Yet another source reported only 71 cases of vocal fold paresis over 7 years. Incidence rates of vocal fold paresis after undergoing thyroid surgery have been reported between 0.3% and 13.2%, whereas these incidence rates are between 2% and 21.6% after undergoing spinal surgery.